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24.5.2.2 Supervision of Home Health Aides
Supervision, as defined by the Texas Nurse Practice act, is the process of directing, guiding, and influencing the outcome of an individual's performance of an activity.
A RN or therapist (PT/OT) must provide the HHA written instructions for all the tasks delegated to the HHA. A therapist may prepare the written instructions if the client is receiving only HHA visits, which do not include delegated SN tasks, in addition to the therapy services.
The requirements for HHA supervision are as follows:
• When only HHA visits are provided, an RN must make a supervisory visit to the client's residence at least once every 60 days. The supervisory visit must occur when the HHA is providing care to the client.
•When SN, PT, and/or OT visits are provided in addition to a HHA visit, an RN must make a supervisory visit to the client's residence at least every two weeks. The supervisory visit must occur when the HHA is providing care to the client.
•When only PT and/or OT visits are provided in addition to HHA visits, the appropriate therapist may make the supervisory visit in place of an RN. The supervisory visit must occur when the HHA is providing care to the client.
•Documentation of HHA supervision must be maintained in the client's medical record.
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